Half-naked bodies writhe on the ground. A man lies in an empty bath, his eyes gazing into space. “No herbs, no medicine. They’ve mixed gutter water together—the eyes are now dirty,” cries out Olamide, a Nigerian rapper. His music video, “Science Student”, has been viewed millions of times. It’s a hypnotic commentary on the chaos caused by the addictive drugs sweeping through his country. But the problem is not just confined to Nigeria. While global headlines have often focused on America’s painkiller addictions, an opioid crisis is raging across west Africa. For decades, Latin American cartels have trafficked cocaine through fragile west African states and on to Europe. Narcotics have often found their way into the region’s conflicts. For example, during Sierra Leone’s war, child soldiers were reportedly given a combination of cocaine and smokeless gunpowder called “brown-brown” that would send them into a killing frenzy. However, many of the hard drugs used in Europe and America are too expensive for those Africans living outside metropolitan areas. This has left a gap in the market for cheap, powerful highs.
Opioids—strong painkillers—have filled that gap. The main ones used in west Africa are tramadol and codeine. These are weaker than their cousins, heroin and fentanyl, but are still potent, especially when combined with substances like cannabis. There are no reliable estimates on how many people in west Africa are taking these opioids, but there is evidence to suggest widespread use across a swathe from Senegal and Mali to Nigeria and Cameroon. The United Nations says that almost 90% of all the pharmaceutical opioids seized in the world in 2016 were seized in Africa (predominantly tramadol, in the west, centre and north). The drugs are mainly manufactured in India. In 2016, following the seizure of 40m tablets, America’s State Department reported that Benin, with a population of just 11m, was the largest importer of Indian tramadol, after the United States.